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Substance abuse treatment centers say they expect to see increased drug and alcohol abuse in the wake of the shootings in Aurora, Colorado, according to The Denver Post. Mental health experts are seeing an extensive need for trauma counseling.

Those affected by the shootings include people who were in the movie theater when the shootings took place, first responders, relatives of victims, and even people without any personal connection to the event, trauma counselors noted.

Experts at Arapahoe House substance abuse treatment center say they expect to see increases in abuse. They pointed out that researchers have documented spikes in use of alcohol, tobacco and other substances after 9/11, the Oklahoma City courthouse bombing and Hurricane Katrina.

“The relationship is high between substance abuse and trauma,” Angela Bornemann, residential Program Manager for Arapahoe House, told the newspaper. “We’ve definitely seen more people come in and people inside of our centers not wanting to go out. A lot of our clients get triggered by this because of a past trauma; it adds to their overall sense of not feeling safe, of wanting to look outside themselves for soothing and coping.”